Suicidal Ideation Therapists in Lititz, PA

Photo of Kay Bela, LPC, Licensed Professional Counselor
Kay Bela
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Lititz, PA 17543
If you've been feeling overwhelmed, stuck, trapped, or like your brain just won't stop ruminating and you're tired, but don't know how to make it stop, I'm here for you. When we're low, life can feel scary, lonely and confusing without a roadmap. I help clients find energy, mental rest, and stability in their lives. We'll take it one step at a time and walk you through mental health recovery at the pace that feels right to you, so you can gain control of your life. I’ve personally dealt with severe anxiety, depression, suicide attempts, trauma, alcohol abuse, & the loss of a brother to addiction, so I'm no stranger to the journey.
If you've been feeling overwhelmed, stuck, trapped, or like your brain just won't stop ruminating and you're tired, but don't know how to make it stop, I'm here for you. When we're low, life can feel scary, lonely and confusing without a roadmap. I help clients find energy, mental rest, and stability in their lives. We'll take it one step at a time and walk you through mental health recovery at the pace that feels right to you, so you can gain control of your life. I’ve personally dealt with severe anxiety, depression, suicide attempts, trauma, alcohol abuse, & the loss of a brother to addiction, so I'm no stranger to the journey.
(717) 229-0116 View (717) 229-0116
Photo of Ambre L. Witte, MSW, LCSW, Clinical Social Work/Therapist
Ambre L. Witte
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Lititz, PA 17543
Hi! My name is Ambre Witte, CEO, LCSW at Life and Love Counseling, LLC. I work with children, adolescents, adults, families, & couples. My clinical focus includes mood instability/ Bipolar Disorder, self-harm/ suicidal ideation, anger/explosive behavior, ODD, PTSD, OCD, Autism, ADHD, Anxiety, Depression, Personality Disorders, etc. My clientele primarily seeks strategies & therapeutic interventions for emotional regulation, non-compliance/defiance, conflict resolution, impulse control, executive functioning, low self-esteem, social skills, self-sufficiency, time management, academic concerns, & family/relationship conflict, etc.
Hi! My name is Ambre Witte, CEO, LCSW at Life and Love Counseling, LLC. I work with children, adolescents, adults, families, & couples. My clinical focus includes mood instability/ Bipolar Disorder, self-harm/ suicidal ideation, anger/explosive behavior, ODD, PTSD, OCD, Autism, ADHD, Anxiety, Depression, Personality Disorders, etc. My clientele primarily seeks strategies & therapeutic interventions for emotional regulation, non-compliance/defiance, conflict resolution, impulse control, executive functioning, low self-esteem, social skills, self-sufficiency, time management, academic concerns, & family/relationship conflict, etc.
(717) 619-9452 View (717) 619-9452
Photo of Tamra Miller-Spence - Redemption Wellness Services, LLC, MS, LPC, Licensed Professional Counselor
Redemption Wellness Services, LLC
Licensed Professional Counselor, MS, LPC
Verified Verified
2 Endorsed
Lititz, PA 17543
Hello, my name is Tamra Miller-Spence. I've worked in the mental health field for about 7 years. I've worked with a variety of client needs, including maternal mental health, domestic violence, anxiety, depression, parenting concerns, relationship discord, trauma, self-harm, suicidal thoughts, and anger management. The clients I work with are seeking guidance in making lifestyle changes to improve their quality of life. They are goal oriented, with an open-mind, and a willingness to be present in sessions.
Hello, my name is Tamra Miller-Spence. I've worked in the mental health field for about 7 years. I've worked with a variety of client needs, including maternal mental health, domestic violence, anxiety, depression, parenting concerns, relationship discord, trauma, self-harm, suicidal thoughts, and anger management. The clients I work with are seeking guidance in making lifestyle changes to improve their quality of life. They are goal oriented, with an open-mind, and a willingness to be present in sessions.
(223) 332-4023 View (223) 332-4023
Photo of Angela Gordon, MS, LPC, Licensed Professional Counselor
Angela Gordon
Licensed Professional Counselor, MS, LPC
Verified Verified
5 Endorsed
Lititz, PA 17543  (Online Only)
You are unique. You cannot be duplicated. You deserve to receive in abundance and to feel capable of giving the best version of yourself to the world. Let's work together to make sure that you always do!
You are unique. You cannot be duplicated. You deserve to receive in abundance and to feel capable of giving the best version of yourself to the world. Let's work together to make sure that you always do!
(717) 455-3289 View (717) 455-3289
Photo of Christopher Stewart, MA, NCC, LPC, Licensed Professional Counselor
Christopher Stewart
Licensed Professional Counselor, MA, NCC, LPC
Verified Verified
2 Endorsed
Lititz, PA 17543  (Online Only)
Hello, I'm Chris. If you've ever felt like you've been alone in society and that you are experiencing a sense of stress related to societal expectations that are unrealistic or built for those who are in a group you feel you don't belong to, I may be a good fit for you. I have an extensive history of working with individuals of various minority group backgrounds, but specialize and focus in working with people who identify within the LGBTQ+ community, including offering affirming services and helping people navigate coming out, family and peer relationships, and romantic and sexual concerns.
Hello, I'm Chris. If you've ever felt like you've been alone in society and that you are experiencing a sense of stress related to societal expectations that are unrealistic or built for those who are in a group you feel you don't belong to, I may be a good fit for you. I have an extensive history of working with individuals of various minority group backgrounds, but specialize and focus in working with people who identify within the LGBTQ+ community, including offering affirming services and helping people navigate coming out, family and peer relationships, and romantic and sexual concerns.
(717) 470-7504 View (717) 470-7504
Photo of Alexis Lake - Lake Therapy LLC, MSS, LCSW, Comm, Inst, AP/IA, Clinical Social Work/Therapist
Lake Therapy LLC
Clinical Social Work/Therapist, MSS, LCSW, Comm, Inst, AP/IA
Verified Verified
Lititz, PA 17543
WE HAVE HIPPA COMPLIANT VIDEO THERAPY available to all Pennsylvania clients. Are you Feeling anxious or out of control? Panicky? Having difficulties with loved ones? I can help. I believe the most important factor in therapy is not the particular style a therapist uses but the relationship between the client and the therapist. I work hard to provide an emotionally safe place where you will be able to connect with me and feel safe enough to tell me your story, your truths. Then together we will better understand where you are, where you'd like to be, and what you might do next to get there.
WE HAVE HIPPA COMPLIANT VIDEO THERAPY available to all Pennsylvania clients. Are you Feeling anxious or out of control? Panicky? Having difficulties with loved ones? I can help. I believe the most important factor in therapy is not the particular style a therapist uses but the relationship between the client and the therapist. I work hard to provide an emotionally safe place where you will be able to connect with me and feel safe enough to tell me your story, your truths. Then together we will better understand where you are, where you'd like to be, and what you might do next to get there.
(717) 931-6690 View (717) 931-6690
Photo of Tonya L. Lane, MS, LPC, Licensed Professional Counselor
Tonya L. Lane
Licensed Professional Counselor, MS, LPC
Verified Verified
1 Endorsed
Lititz, PA 17543
Hi! My name is Tonya Lane, LPC at Life and Love Counseling, LLC. I work with children, adolescents, adults, & families, with a specific emphasis on helping preschool-aged & preadolescent children. My role often extends to the children's families & their circumstances that impact their lives; education, community, & legal matters. I will often communicate with outside agencies & schools to facilitate collaboration. My clinical focus includes ADHD, ODD, PTSD, Autism, Anxiety, Depression, Developmental Disorders, & Learning Disabilities, Academic Concerns, Time Management, Boundary-Setting, Parenting, Healthy Eating, Work/Life Balance.
Hi! My name is Tonya Lane, LPC at Life and Love Counseling, LLC. I work with children, adolescents, adults, & families, with a specific emphasis on helping preschool-aged & preadolescent children. My role often extends to the children's families & their circumstances that impact their lives; education, community, & legal matters. I will often communicate with outside agencies & schools to facilitate collaboration. My clinical focus includes ADHD, ODD, PTSD, Autism, Anxiety, Depression, Developmental Disorders, & Learning Disabilities, Academic Concerns, Time Management, Boundary-Setting, Parenting, Healthy Eating, Work/Life Balance.
(717) 553-0621 View (717) 553-0621
Photo of Ambre L. Witte - Life and Love Counseling, LLC., MSW, LCSW, Clinical Social Work/Therapist
Life and Love Counseling, LLC.
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Lititz, PA 17543
Hi! We are Life and Love Counseling, LLC., a caring outpatient psychotherapy office, located in Lancaster, PA providing mental health services, life coaching, & holistic therapies for individuals (children ages 3+, adolescents, & adults), families, couples, & groups. When life becomes overwhelming, psychotherapy offers therapeutic support, encouragement, psychoeducation, & facilitates the implementation of problem-solving strategies to navigate difficult & challenging times. We utilize CBT strategies to address negative thoughts, feelings, & behaviors. We offer holistic approaches to attain balance & awaken an inner calm.
Hi! We are Life and Love Counseling, LLC., a caring outpatient psychotherapy office, located in Lancaster, PA providing mental health services, life coaching, & holistic therapies for individuals (children ages 3+, adolescents, & adults), families, couples, & groups. When life becomes overwhelming, psychotherapy offers therapeutic support, encouragement, psychoeducation, & facilitates the implementation of problem-solving strategies to navigate difficult & challenging times. We utilize CBT strategies to address negative thoughts, feelings, & behaviors. We offer holistic approaches to attain balance & awaken an inner calm.
(717) 454-2068 View (717) 454-2068
Photo of Joseph H Lucas - Advanced Counseling and Testing Solutions, LLC., PsyD, ABSNP, Licensed Professional Counselor
Advanced Counseling and Testing Solutions, LLC.
Licensed Professional Counselor, PsyD, ABSNP
Verified Verified
Lititz, PA 17543
Thanksgiving is approaching! Do you want to improve your emotional wellness? ACTS is accepting new clients for Counseling/Psychotherapy, Neurofeedback, and Testing. ACTS is a reputable practice with a seasoned group of professionals with a long-standing reputation for helping clients achieve results. Relationship challenges, experiencing turmoil or simply need solutions to life's problems, ACTS is here! Stressed, depressed, anxious, feel overwhelmed; child having learning or behavioral challenges? ACTS excels at creating solutions to life's problems, in a caring & empathic environment. Call today & focus on yourself or your child!
Thanksgiving is approaching! Do you want to improve your emotional wellness? ACTS is accepting new clients for Counseling/Psychotherapy, Neurofeedback, and Testing. ACTS is a reputable practice with a seasoned group of professionals with a long-standing reputation for helping clients achieve results. Relationship challenges, experiencing turmoil or simply need solutions to life's problems, ACTS is here! Stressed, depressed, anxious, feel overwhelmed; child having learning or behavioral challenges? ACTS excels at creating solutions to life's problems, in a caring & empathic environment. Call today & focus on yourself or your child!
(717) 523-9273 View (717) 523-9273
Photo of Heather Apple-Jenkins, MEd, RLT, TF-CBT
Heather Apple-Jenkins
MEd, RLT, TF-CBT
Verified Verified
1 Endorsed
Lititz, PA 17543
Therapy is about giving the Client his/her/their voice to fully and safely express his/her/their thoughts, feelings and stories without feeling judged. It is helping the Client see clearly their role and place in life and to find the Hero within Themselves. The Client will be Empowered to lead and enjoy their lives as productively as possible despite past or present hardships.
Therapy is about giving the Client his/her/their voice to fully and safely express his/her/their thoughts, feelings and stories without feeling judged. It is helping the Client see clearly their role and place in life and to find the Hero within Themselves. The Client will be Empowered to lead and enjoy their lives as productively as possible despite past or present hardships.
(717) 388-2629 View (717) 388-2629
Photo of Lisa M. Speck-Casadei della Chiesa - Balanced Life Counseling, LPC, LCSW, LMFT, LMT, NCHC, Licensed Professional Counselor
Balanced Life Counseling
Licensed Professional Counselor, LPC, LCSW, LMFT, LMT, NCHC
Verified Verified
Lititz, PA 17543
It is our belief that we all have the capacity to change, heal and recover from all the things that life can throw at us. At Balanced Life Counseling, we strive to create a warm, welcoming, and trusting environment which allows us to work together towards your goals. Are you feeling overwhelmed by the pressures and stress of life? Has communication been difficult lately? Are you looking for support to navigate challenging situations or circumstances? Sometimes, it's about something more than change. It's about growth and we are passionate about joining with our clients in a safe and collaborative space to help empower their growth.
It is our belief that we all have the capacity to change, heal and recover from all the things that life can throw at us. At Balanced Life Counseling, we strive to create a warm, welcoming, and trusting environment which allows us to work together towards your goals. Are you feeling overwhelmed by the pressures and stress of life? Has communication been difficult lately? Are you looking for support to navigate challenging situations or circumstances? Sometimes, it's about something more than change. It's about growth and we are passionate about joining with our clients in a safe and collaborative space to help empower their growth.
(717) 539-4178 View (717) 539-4178
Photo of Shanna Harvey, MA, NCC, RYT, Pre-Licensed Professional
Shanna Harvey
Pre-Licensed Professional, MA, NCC, RYT
Verified Verified
3 Endorsed
Lititz, PA 17543
I believe every challenge we experience is an opportunity to strengthen ourselves and to enhance our self-awareness. Holding the belief that each of us are living for a unique purpose, I am delighted to help people find meaning in their difficult experiences. I feel passionate about aiding others in reaching their personal goals. In the therapist role, I aim to help my clients find a sense of empowerment from within, as it is up to us to tap into our full potential. My therapeutic approach is dynamic and depends on the needs of each person. I welcome clients who are motivated to create healthy positive change.
I believe every challenge we experience is an opportunity to strengthen ourselves and to enhance our self-awareness. Holding the belief that each of us are living for a unique purpose, I am delighted to help people find meaning in their difficult experiences. I feel passionate about aiding others in reaching their personal goals. In the therapist role, I aim to help my clients find a sense of empowerment from within, as it is up to us to tap into our full potential. My therapeutic approach is dynamic and depends on the needs of each person. I welcome clients who are motivated to create healthy positive change.
(717) 294-0528 View (717) 294-0528
Photo of Beth Jones Accepting New Clients, LSW, Clinical Social Work/Therapist
Beth Jones Accepting New Clients
Clinical Social Work/Therapist, LSW
Verified Verified
1 Endorsed
Lititz, PA 17543
Are you or your teen struggling with anxiety, depression,or stress? Allow me to help! With over 30 years' experience working in mental health, I recognize the importance of trauma informed care practices. I work to create a safe space to process past experiences, that continue to make achieving personal goals difficult. Identifying and building upon strengths that an individual already has is paramount in my approach, and together we focus on fostering mindfulness techniques in developing coping strategies to address depression, anxiety and day to day challenges.
Are you or your teen struggling with anxiety, depression,or stress? Allow me to help! With over 30 years' experience working in mental health, I recognize the importance of trauma informed care practices. I work to create a safe space to process past experiences, that continue to make achieving personal goals difficult. Identifying and building upon strengths that an individual already has is paramount in my approach, and together we focus on fostering mindfulness techniques in developing coping strategies to address depression, anxiety and day to day challenges.
(717) 987-7965 View (717) 987-7965
Photo of Gracey Lum, MA, Pre-Licensed Professional
Gracey Lum
Pre-Licensed Professional, MA
Verified Verified
Lititz, PA 17543
I am passionate about fostering positive client relationships across diverse age groups. Particularly, I have experience in supporting children and adolescents with a variety of diagnoses and behavioral challenges. My approach revolves around collaboratively aiding individuals, couples, and families in learning about themselves and others in the midst of life’s challenges. I aim to meet the unique needs of each client by integrating a variety of therapeutic techniques including Family Systems, Cognitive Behavioral Therapy (CBT), and person-centered strategies.
I am passionate about fostering positive client relationships across diverse age groups. Particularly, I have experience in supporting children and adolescents with a variety of diagnoses and behavioral challenges. My approach revolves around collaboratively aiding individuals, couples, and families in learning about themselves and others in the midst of life’s challenges. I aim to meet the unique needs of each client by integrating a variety of therapeutic techniques including Family Systems, Cognitive Behavioral Therapy (CBT), and person-centered strategies.
(717) 667-8213 View (717) 667-8213
Photo of Brooke Swinehart Open Availability, LSW, Clinical Social Work/Therapist
Brooke Swinehart Open Availability
Clinical Social Work/Therapist, LSW
Verified Verified
Lititz, PA 17543
Welcome! Do you find yourself struggling with daily tasks, and feel drained daily due to mental health struggles? Do you feel unequipped with a lack of coping skills regarding your struggles? Do you experience depression, anxiety, hopelessness, or an inability to cope? Allow me to help! I have past experiences working with individuals struggling with depression, anxiety, personality disorders, trauma, grief and loss, substance use co-occurring with mental health, and more. Together we can build a dynamic where your symptoms will feel more manageable, and your life will begin to improve and feel more manageable.
Welcome! Do you find yourself struggling with daily tasks, and feel drained daily due to mental health struggles? Do you feel unequipped with a lack of coping skills regarding your struggles? Do you experience depression, anxiety, hopelessness, or an inability to cope? Allow me to help! I have past experiences working with individuals struggling with depression, anxiety, personality disorders, trauma, grief and loss, substance use co-occurring with mental health, and more. Together we can build a dynamic where your symptoms will feel more manageable, and your life will begin to improve and feel more manageable.
(717) 864-4651 View (717) 864-4651
Photo of Heatherstone Counseling Services New Clients Welcome, MS, LPC, LSW, MSW, CAADC, Licensed Professional Counselor
Heatherstone Counseling Services New Clients Welcome
Licensed Professional Counselor, MS, LPC, LSW, MSW, CAADC
Verified Verified
3 Endorsed
Lititz, PA 17543
Are you feeling anxious, depressed, or overwhelmed? At Heatherstone Counseling Services, we believe that a warm, caring, and supportive therapeutic relationship is imperative to the success of our clients. Building trust, and helping people work towards achieving their personal goals is what we strive to do in each and every session. We understand that challenges and difficult moments can be a part of the therapy process, and we aim to support our clients as they move through those experiences. Our hope is that each and every person that we meet in practice will experience personal growth, self understanding, and improved health.
Are you feeling anxious, depressed, or overwhelmed? At Heatherstone Counseling Services, we believe that a warm, caring, and supportive therapeutic relationship is imperative to the success of our clients. Building trust, and helping people work towards achieving their personal goals is what we strive to do in each and every session. We understand that challenges and difficult moments can be a part of the therapy process, and we aim to support our clients as they move through those experiences. Our hope is that each and every person that we meet in practice will experience personal growth, self understanding, and improved health.
(717) 537-9470 View (717) 537-9470
Photo of Rachel Gerrity, Pre-Licensed Professional
Rachel Gerrity
Pre-Licensed Professional
Verified Verified
Lititz, PA 17543
Therapy allows you to explore your life and discover who you are in the setting of a safe and caring relationship. In our work together, I will accept and honor you precisely as you are, recognizing your strengths and engaging in the difficult times of your life with empathy and hope. My goal is to provide a safe and supportive environment in which you may find yourself and go forward with courage and confidence. I work with individuals who are seeking help with anxiety, life transitions, eating disorders, body image difficulties, gender/sexuality affirmation, trauma, and LGBTQIA+ populations.
Therapy allows you to explore your life and discover who you are in the setting of a safe and caring relationship. In our work together, I will accept and honor you precisely as you are, recognizing your strengths and engaging in the difficult times of your life with empathy and hope. My goal is to provide a safe and supportive environment in which you may find yourself and go forward with courage and confidence. I work with individuals who are seeking help with anxiety, life transitions, eating disorders, body image difficulties, gender/sexuality affirmation, trauma, and LGBTQIA+ populations.
(717) 931-6361 View (717) 931-6361
Photo of Laney Rapsey, MS, LPC, Licensed Professional Counselor
Laney Rapsey
Licensed Professional Counselor, MS, LPC
Verified Verified
2 Endorsed
Lititz, PA 17543
I love to see my clients discover and learn to empower themselves to be exactly who they are and to live the life they want for themselves. Sometimes feeling overwhelmed by certain emotions, stressful life events, or self-doubt can make it difficult to identify and utilize your strengths, to feel good about yourself, and to make the changes you want. I work with my clients to help them use the strengths they already have as well as to learn new skills to help them remember just how capable they are and to further empower them to work towards the change they want.
I love to see my clients discover and learn to empower themselves to be exactly who they are and to live the life they want for themselves. Sometimes feeling overwhelmed by certain emotions, stressful life events, or self-doubt can make it difficult to identify and utilize your strengths, to feel good about yourself, and to make the changes you want. I work with my clients to help them use the strengths they already have as well as to learn new skills to help them remember just how capable they are and to further empower them to work towards the change they want.
(717) 276-4675 View (717) 276-4675
Photo of Lauren Baker, LCSW, Clinical Social Work/Therapist
Lauren Baker
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
Lititz, PA 17543
As a Licensed Clinical Social Worker (LCSW), I am trained to help guide you through life’s ups and downs based on your achievements and assets. From the social work perspective, we can focus on holistically working towards effective change rather than just on your symptoms or diagnosis. This includes your successes, barriers, family history, support systems, community, and anything else that makes you uniquely you. I am EMDR Certified and specialize in EMDR and IFS informed EMDR to treat acute and chronic PTSD as well as perinatal mental health and anxiety / mood disorders.
As a Licensed Clinical Social Worker (LCSW), I am trained to help guide you through life’s ups and downs based on your achievements and assets. From the social work perspective, we can focus on holistically working towards effective change rather than just on your symptoms or diagnosis. This includes your successes, barriers, family history, support systems, community, and anything else that makes you uniquely you. I am EMDR Certified and specialize in EMDR and IFS informed EMDR to treat acute and chronic PTSD as well as perinatal mental health and anxiety / mood disorders.
(223) 215-5211 View (223) 215-5211
Photo of Katherina Kapur, LSW, CAADC, Clinical Social Work/Therapist
Katherina Kapur
Clinical Social Work/Therapist, LSW, CAADC
Verified Verified
Lititz, PA 17543
Are you struggling with emotions, trauma, or persistent negative thoughts? Is your child struggling with their behaviors, emotions or school functioning? Have your relationships, marriage or partnership experienced trouble, or need a "tune up?" You have come to the right place. Hi! My name is Katie Kapur, and I am here to help you acheive your goals, improve your relationships and increase life satisfaction. I care about my clients, and value the time I spend with each and every person I have the pleasure of working with.
Are you struggling with emotions, trauma, or persistent negative thoughts? Is your child struggling with their behaviors, emotions or school functioning? Have your relationships, marriage or partnership experienced trouble, or need a "tune up?" You have come to the right place. Hi! My name is Katie Kapur, and I am here to help you acheive your goals, improve your relationships and increase life satisfaction. I care about my clients, and value the time I spend with each and every person I have the pleasure of working with.
(717) 973-6870 View (717) 973-6870
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Suicidal Ideation Therapists

How does therapy for suicidal ideation work?

Stress, depression, anxiety, or upsetting circumstances can give rise to suicidal thinking. Therapy can address the events at the core of an individual’s suffering. Understanding why a person may be suicidal can help the therapist and the patient discover alternative methods of coping. A person with suicidal ideation may be mired in catastrophic thinking, and treatment like cognitive behavioral therapy is a good choice for breaking such patterns. In addition, treatment such as acceptance and commitment therapy can help a person manage their distress through better emotion regulation.

Which therapies are best for suicidal ideation?

Specific approaches used by professionals include cognitive behavioral, dialectical behavior, psychodynamic, acceptance and commitment therapies, among others. Cognitive behavioral and dialectical behavior therapies are two widely used therapies that can help individuals with painful thoughts and past traumas. These therapies help an individual tolerate distress, regulate emotions, and not act on dangerous urges.

Are there specific medications to be combined with therapy?

The use of medication for suicidal thoughts must be aligned with the underlying cause; conditions such as depression, anxiety, and psychosis may be at the root of suicidal ideation. A psychiatrist may prescribe medications for symptoms, which may include antipsychotics such as aripiprazole or antidepressants such as selective serotonin reuptake inhibitors.

How often and how long are therapy sessions for suicidal ideation?

As with any type of therapy, sessions depend on the individual. Patients may see improvement within 15 to 20 sessions, at an average of 50 minutes per session, while others may opt for 20 to 30 sessions over, perhaps, a six-month period. Still other patients, especially those with co-occurring conditions like major depression and anxiety, may need to continue sessions for up to 12 to 18 months. In some cases, residential treatment may be recommended for an individual who is judged to be at high risk of self-harm.